Download How do Special Forces Operations access quality blood products for

How do Special Forces Operations
access quality blood products for
military personnel?
Collected in March 2014
What is this research about?
In brief…
Canada’s Special Forces operate in extreme conditions and
dangerous environments. When a soldier is injured, blood is
With specialized transport boxes, the
required, but transporting blood under battlefield conditions presents
Canadian Forces can get quality red
challenges. Blood products must be transported through extreme
blood cell products to their injured
environmental conditions where they can be sent to battlefield
personnel in the field, even in
locations by parachute descent followed by long distance treks
extreme environments.
(usually in the backpack of patrol soldiers) over rugged terrain in
extreme environmental temperatures. The stress of these transport
conditions may impact the quality of the blood products and potentially limit their clinical effectiveness or even
have a negative clinical impact. Canadian Blood Services and the Canadian Forces have worked together to
evaluate the impact of mechanical agitation and environmental temperature extremes on the quality of red
blood cells, one of the blood products distributed to the military by Canadian Blood Services. This collaborative
study brought together the unique quality testing expertise that exists within Canadian Blood Services
Research & Development group and the Canadian Forces ability to simulate Special Forces operations to
resolve a real world problem.
What did the researchers do?
Canadian Blood Services research clinic in Vancouver collected whole blood from deferred volunteer blood
donors. Whole blood was manufactured to obtain 20 packed red blood cell units (red blood cells separated
from whole blood), a normal procedure for transfusion purposes. The units were pooled and split to create
enough units to support the study. One sample from each pool was tested as a control to determine the quality
prior to shipment to Toronto where the Special Forces operation was simulated. The simulated Special Forces
operation placed red blood cell units in specialized blood transport boxes and replicated a high altitude low
opening parachute descent and 12 h transport in a backpack at 48 ˚C with 9 % humidity using a hyperbaric
chamber and participants running on a treadmill. This simulation was representative of an Afghan summer.
Samples were taken throughout the simulation. These samples were tested immediately on site and then sent
to Canadian Blood Services research laboratories for a more detailed evaluation of red blood cell quality. All
data collected was analyzed to determine if the mechanical agitation and environmental temperature extremes
had an impact on the quality of the red blood cells.
What did the researchers find?
No significant differences were identified between control and test red blood cells at any time point during
the simulation.
ResearchUnit is a knowledge mobilization tool developed by Canadian Blood Services (available online at blood.ca)
No impact on the quality of the packed red blood cell units was identified in this study. The specially
designed transport boxes were able to maintain an environment within which the quality of the red blood cells
was maintained even when conditions were extreme.
How can you use this research?
Degradation of red blood cell quality may have pathological consequences upon transfusion, especially when
massive transfusion is required, such as in trauma cases. Therefore, Canadian Forces Health Services
program must be confident that red blood cell quality can be maintained even in extreme environmental
conditions. The evidence collected during this study demonstrates that the specialized transport boxes are able
to maintain the quality of red blood cells during a short Special Forces operation.
About the research team: Dr. Jason Acker is a Senior Development Scientist with Canadian Blood Services. Dr Acker is also a
Professor in the Department of Laboratory Medicine and Pathology at the University of Alberta. His research lab specializes in
understanding the impact of storage of packed red blood cell units on red blood cell quality in vitro while attempting to understand the
connection of in vitro quality to in vivo outcomes. Major Andrew Beckett MD is a Critical Care Fellow at Sunnybrook Hospital and a
Trauma Surgeon at the Canadian Forces. His research interest is in making a positive impact on the way casualties are treated in the
field. Dr. Cathy Boscarino is a Scientist with Defence Research & Development Canada, Toronto in the Individual Behaviour and
Performance Section. Dr Boscarino’s research interest is in medical science particularly gene expression and clinical
markers/symptoms. The DRDC focuses its science and technology expertise in areas of critical importance to current and future
Canadian Forces operations and public security.
This ResearchUnit is derived from the following publications:
[1] Boscarino C, Acker J, Hansen A, Tien H, Callum J, Engels P, Beckett B. Feasibility and transport of packed red blood cells into
special forces operational conditions. Journal of Trauma and Acute Care Surgery (2014) 76; 4: 1013-19.
[2] This work was presented at the Military Health System Research Symposium on August 14, 2012 in Fort Lauderdale, Florida.
Acknowledgements: This research received financial support from the Canadian Forces Health Services Program and from Canadian
Blood Services Blood Research and Development Program funded by the federal (Health Canada), provincial and territorial Ministries
of Health. The views expressed herein do not necessarily represent the view of the federal government. Canadian Blood Services is
grateful to blood donors for making this research possible.
Keywords: Packed Red Blood Cells, Quality, Special Forces Operations.
Want to know more? Contact Dr. Jason Acker at [email protected].
ResearchUnit is a knowledge mobilization tool developed by Canadian Blood Services (available online at blood.ca)